title: Nursing home quality and financial performance: does the racial composition of residents matter?
abstract: OBJECTIVE
  To examine the effects of the racial composition of residents on nursing homes' financial and quality performance. The study examined Medicare and Medicaid-certified nursing homes across the United States that submitted Medicare cost reports between the years 1999 and 2004 (11,472 average per year).
  
  
  METHODS
  Data were obtained from the Minimum Data Set, the On-Line Survey Certification and Reporting, Medicare Cost Reports, and the Area Resource File.
  
  
  METHODS
  Panel data regression with random intercepts and negative binomial regression were conducted with state and year fixed effects.
  
  
  RESULTS
  Financial and quality performance differed between nursing homes with high proportions of black residents and nursing homes with no or medium proportions of black residents. Nursing homes with no black residents had higher revenues and higher operating margins and total profit margins and they exhibited better processes and outcomes than nursing homes with high proportions of black residents.
  
  
  CONCLUSIONS
  Nursing homes' financial viability and quality of care are influenced by the racial composition of residents. Policy makers should consider initiatives to improve both the financial and quality performance of nursing homes serving predominantly black residents.
authors.affiliation: Department of Health Management and Informatics, University of Central Florida, Orlando, FL.
authors.forename: Latarsha
authors.initials: L
authors.lastname: Chisholm
authors.forename: Robert
authors.initials: R
authors.lastname: Weech-Maldonado
authors.forename: Alex
authors.initials: A
authors.lastname: Laberge
authors.forename: Feng-Chang
authors.initials: FC
authors.lastname: Lin
authors.forename: Kathryn
authors.initials: K
authors.lastname: Hyer
mesh_terms: D001741:Black or African American; D019985:Benchmarking; D005376:Financial Management / Q000592:standards / Q000706:statistics & numerical data*; D006707:Homes for the Aged / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D008484:Medicaid / Q000706:statistics & numerical data; D006278:Medicare / Q000706:statistics & numerical data; D009735:Nursing Homes / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D014481:United States
keywords: Nursing homes; blacks; financial performance; quality; racial composition